Hi.

A dermatologist would be able to help you.
You may either visit a dermatologist in your region Or else you may also post me a direct query on my profile along with a few good quality images of the affected area: http://doctor.healthcaremagic.com/doctors/dr-kakkar-s/66939

Regards

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Brief Answer:
Kindly upload any image of the effected area

Detailed Answer:
Hello and welcome to healthcaremagic.
I have taken note of your query.
I request you to upload any image of the effected area so that I can guide you better.
You can upload an image at reports section or you may also mail me the image at YYYY@YYYY
Kindly mention the subject of this mail as attention Dr. Kakkar.
Regards

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Brief Answer:
possibility of lichen planus pigmentosus or lichenoid drug eruption.

Detailed Answer:
Hi.

I have reviewed the Images.

I can see ill-defined greyish brown marks appear on the face and neck or trunk and limbs.

I suggest a possibility of Lichen Planus Pigmentosus/ LPP Or it is a lichenoid drug eruption.

-Can you also upload the biopsy report?
-Are there any symptoms like itching etc?
-Also let me know whether is there is any facial involvement with similar lesions?
-Are you on some other oral medication for an unrelated condition?

Treatment options for Lichen planus pigmentosus would include topical steroids and Oral antimalarials like hydroxychloroquin

Regards

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Brief Answer:
Lichen planus pigmemtosus; topical moderately potent steroids

Detailed Answer:
Hi.

Thank you for additional information.
I will like to keep a very likely possibility of Lichen Planus Pigmentosus/ LPP.

In LPP lesions are usually bluish or slate grey in color, asymptomatic and can have either a diffuse or reticular or blotchy distribution.
The distribution of lesions in your case seems to be blotchy and reticular..

I would suggest a skin Biopsy, if not already done for a confirmatory diagnosis... Diagnosis of LPP is usually obvious on histopathology and would reveal basal cell degeneration and pigment incontinence.

Treatment is with topical moderately potent steroid like mometasone furoate Or superpotent steroids like clobetasol propionate, twice daily.
Oral hydroxychloroquin can also be started.

Pigmentation is slow to respond and it may take months (4-6 months) of treatment with topical steroids to fade away the lesions.

These dark skin lesions are not of lupus.

Positive test for lupus (ANA) can be present in 10 % of normal adult population and in the absence of other signs and symptoms of lupus is of no significance.
Though patients with a positive lupus test can be monitored for sign & symptoms of lupus that may develop in future.

Bruising is unrelated and needs to be investigated separately.

Regards

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